中国中西医结合肾病杂志
中國中西醫結閤腎病雜誌
중국중서의결합신병잡지
CHINESE JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN NEPHROLOGY
2015年
2期
116-120
,共5页
钱春梅%王秦%李军辉%范瑛%汪年松%盛晓华
錢春梅%王秦%李軍輝%範瑛%汪年鬆%盛曉華
전춘매%왕진%리군휘%범영%왕년송%성효화
维持性血液透析%死亡原因%心脑血管疾病%感染%肿瘤
維持性血液透析%死亡原因%心腦血管疾病%感染%腫瘤
유지성혈액투석%사망원인%심뇌혈관질병%감염%종류
Maintenance hemodialysis%Cause of death%Cardiovascular disease%Infection%Tumour
目的：：探讨维持性血液透析患者主要死亡原因及影响因素。方法：回顾性分析2008年1月~2013年12月上海市第六人民医院及上海市第六人民医院南院行维持性血液透析患者资料，剔除透析龄<3月患者，共计380例，死亡患者96例，分析患者的死亡原因及影响因素。结果：96例死亡病例中男62例，女34例，主要死亡原因为：心脑血管疾病48例(50%)，感染性疾病18例(18.75%)，肿瘤16例(16.67%)。<60岁28例，≥60岁68例，其中糖尿病患者居多。高血磷组(>1.45 mmol/L)患者心血管疾病死亡率明显高于正常血磷组(≤1.45 mmol/L)，差异有统计学意义，提示血磷水平越高，心血管死亡风险越大。 Logistic回归分析提示白蛋白、尿素氮、肌酐是MHD患者死亡的危险因素。与非心脑血管疾病死亡患者相比，死于心脑血管疾病的患者其透析龄较短，血清肌酐、血红蛋白、白蛋白、三酰甘油、胆固醇均较高。结论：心脑血管疾病是维持性血液透析患者最主要的死亡原因，其次为感染和肿瘤；糖尿病是影响预后的重要原因，控制血磷水平，有助于减少死亡风险。
目的：：探討維持性血液透析患者主要死亡原因及影響因素。方法：迴顧性分析2008年1月~2013年12月上海市第六人民醫院及上海市第六人民醫院南院行維持性血液透析患者資料，剔除透析齡<3月患者，共計380例，死亡患者96例，分析患者的死亡原因及影響因素。結果：96例死亡病例中男62例，女34例，主要死亡原因為：心腦血管疾病48例(50%)，感染性疾病18例(18.75%)，腫瘤16例(16.67%)。<60歲28例，≥60歲68例，其中糖尿病患者居多。高血燐組(>1.45 mmol/L)患者心血管疾病死亡率明顯高于正常血燐組(≤1.45 mmol/L)，差異有統計學意義，提示血燐水平越高，心血管死亡風險越大。 Logistic迴歸分析提示白蛋白、尿素氮、肌酐是MHD患者死亡的危險因素。與非心腦血管疾病死亡患者相比，死于心腦血管疾病的患者其透析齡較短，血清肌酐、血紅蛋白、白蛋白、三酰甘油、膽固醇均較高。結論：心腦血管疾病是維持性血液透析患者最主要的死亡原因，其次為感染和腫瘤；糖尿病是影響預後的重要原因，控製血燐水平，有助于減少死亡風險。
목적：：탐토유지성혈액투석환자주요사망원인급영향인소。방법：회고성분석2008년1월~2013년12월상해시제륙인민의원급상해시제륙인민의원남원행유지성혈액투석환자자료，척제투석령<3월환자，공계380례，사망환자96례，분석환자적사망원인급영향인소。결과：96례사망병례중남62례，녀34례，주요사망원인위：심뇌혈관질병48례(50%)，감염성질병18례(18.75%)，종류16례(16.67%)。<60세28례，≥60세68례，기중당뇨병환자거다。고혈린조(>1.45 mmol/L)환자심혈관질병사망솔명현고우정상혈린조(≤1.45 mmol/L)，차이유통계학의의，제시혈린수평월고，심혈관사망풍험월대。 Logistic회귀분석제시백단백、뇨소담、기항시MHD환자사망적위험인소。여비심뇌혈관질병사망환자상비，사우심뇌혈관질병적환자기투석령교단，혈청기항、혈홍단백、백단백、삼선감유、담고순균교고。결론：심뇌혈관질병시유지성혈액투석환자최주요적사망원인，기차위감염화종류；당뇨병시영향예후적중요원인，공제혈린수평，유조우감소사망풍험。
Objective:To investigate the leading causes of death and related factors in maintenance hemodialysis( MHD) pa-tients. Methods:We retrospectively analyzed the MHD patients treated in Shanghai Jiaotong University Affiliated Sixth People Hospi-tal and Shanghai Jiaotong University Affiliated Sixth People Hospital South Campus in the period of Jan. 2008 to Dec. 2013. Elimina-ted the patients treated less than three month. There were 380 patients total, 96 patients died. Analysis the causes of death of patients and affected factors. Results:In the 96 death cases, 62 cases were males and 34 cases were females. The main causes of mortality were cardiovascular and cerebrovascular diseases(48,50%), infectious diseases(18,18. 75%),malignancies(16,16. 67%). 48 ca-ses were older than 60. Diabetic nephropathy was frequently found in elderly group. Cardiovascular mortality in patients with high blood phosphorus( >1. 45 mmol/L)was significantly higher than normal blood phosphorus(≤1. 45 mmol/L). There was statistical significance. That means higher blood phosphorus accompanied higher risk of death on cardiovascular. Logistic regression analysis showed that albumin, urea nitrogen, serum creatinine maybe the risk fators of MHD patients. Compared with the non-cardiovascular and cerebrovascular diseases, die of cardiovascular and cerebrovascular diseases, it’ s dialysis age was shorter,and serum creatinine, HB, albumin, triglyceride, and cholesterol were higher. Conclusion:In maintenance hemodialysis patients, the main cause of death was cardiovascular and cerebrovascular disease, the second was infection and tumor. Diabetes was the important factor affecting the prognosis. Control blood phosphorus levels maybe reduce the mortality.
